📝 COMPLETE A QUOTE

We are specialist brokers who help you find the most competitive arrangement.
Please take 5-10 minutes to fill in the form below. This form contains the necessary information that enables us to quote on your behalf.

New fact find form

CONTACT DETAILS

First Name *

Surname *

Date of Birth

Phone Number *

Business Address *

* Please provide us with your complete address. If you cannot find your address, please click the "Unable to Find The Address" option below.

I am unable to find the address

Section

Street Number/Name *

Suburb pEnter 4 letters of SUBURB *

States *

Post Code *

Email Address *

How did you find us

If other, please provide details: *

All information you provide must be correct, true, and accurate as incorrect or misleading information may alter our quote and jeopardise cover if you proceed with a policy.

Please refer to the Financial Services Guide, Privacy Statement and Duty of Disclosure before completing this form.

INSURED

Section

Trading name (if applicable):

What is the business you are involved in? This section is for plant and equipment operators and operators who use heavy vehicles as part of their business. to describe the type of work/business they are involved in. Refer to the Occupations guide for more information. *

Number of years operating this business: *

ABN *

Entity Name

🔍 Search the Australian Business Register
ABN Lookup

Click the ABN => Entity Name button to transfer ABN to the Entity Name

ABN => Entity

Motor Vehicle Insurance or Machinery Insurance Required ? *

Yes

Item 1

Type of Cover Select your type of cover

Year of Make *

Body Type *

Other Body Type *

Crane

Make, Age Of Crane Assembly *

Where Was Crane Manufactured *

Is Manufacturer Still In Business *

Yes

Not sure

Date Of Last 6 Yearly Inspection Or Rebuild *

Type Of Registration And Registation Number, If Applicable *

Sum Insured *

Is A Current Maintenance Logbook Kept For Every Crane As Required By As As2550.4 And/Or As2550.5? *

Yes

Are All Units Fully Maintained By A Formal Preventative Maintenance Program As Outlined In The Same Australian Standard? *

Yes

Is A Jsa (Job Safety Statement) Or Swms (Safe Work Method Statement) Completed By A Supervisor Or Manager Before Works Commence On Major Construction Sites ? *

Yes

What Is The Operators’ Years Of Experience With Using This Type Of Equipment? *

Are Operators Issued With A Sop (Safe Operating Procedures) Manual ? *

Yes

Are Operators Instructed To Complete A Pre-Trip / Daily Visual Inspection Of Their Unit And Is This

Checked By Supervisor / Manager ? *

Yes

If Yes, Please Provide Details *

Have You Ever Had A Crane Collapse Or Fall Over When Operating ? *

Yes

If Yes, Please Provide Full Details Of Circumstances, Make And Age Of Crane And Amount Of Damage Caused *

Are There Any Overseas Manufactured Units To Be Insured That :

In The Event Of Damage, Do Not Have Parts Available Locally And / Or The Requisite Expertise To Be Able To Conduct Repairs In Australia ? *

Yes

If Yes, Please Provide Full Details Of Items *

Are Subject To Warranty Conditions, Which Would Inhibit Warranty Repairs Being Conducted In Australia ? *

Yes

If Yes, Please Provide Full Details Including Relevant Items *

Please Advise The Nature Of Goods Being Lifted

Please Advise If Any Items May Be Used On A Barge, Under Or Over Water Or For Stevedoring Services ? *

Yes

If Yes, And You Require Cover To Be Extended Please Refer To Questionnaire

Do You Perform Any Work Or Service In Any Airside Area Of An Airport ? *

Yes

Bobcat/Mini/Trailer Vacuum Excavator *

Bus *

Coach *

Crusher / screening *

Drill/ Piler *

Dump truck (off road) *

Earth moving plant *

Forklift & other moving equipment *

Forest *

GPS/ laser leveller *

Harvesting equipment *

Miscellaneous plant and equipment *

Motorcycle *

Road making machines *

Rigid truck *

Tree small equipment *

Truck mounted drill/ excavation

Underground mining

Make *

Model

Vehicle Accessories/Modifications (if applicable)

Garaging / Storage Address *

Please provide us with your complete Garaging Address. If your garaging address matches your personal address, please click the Same as personal address option.

Same as personal address

Vehicle Sum insured The sum insured is the market value of the vehicle or trailer. It is the value for which the vehicle or trailer and its accessories could be sold. This value is exclusive of GST. *

Radius of operation: This is the maximum distance you will travel while carrying this cargo *

🔍 Straight-Line Distance Calculator

Is this item registered: *

Yes

Provide Reg No. *

GVM

Carrying Capacity *

Type of License *

On - Hook Coverage:

Do you require On-Hook coverage ? *

Yes

If yes, specify the sum insured amount: *

Items Towed:

Please tick all that apply:

Items Towed:

Cars

Caravans

Boats

Machinery

Other

Please specify: *

Add Remove

USAGE

Fully describe what the vehicle / truck / machinery / plant / trailer, will be used for: *

Section

Is the vehicle / truck / machinery / plant / trailer, involved in work at locations above the 26th degree parallel in Western Australia or Northern Territory ?

Yes

Not sure